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Urban Guerrilla Gardening and Health  

Alec Thornton

The benefits of gardening for mental and physical health are well known. Gardening is also recognized as a local-level or grassroots response to the negative effects of climate change and global warming. In urban areas, dense neighborhoods, limited green spaces, contaminated brownfield sites, and, at times, restrictive council regulations on the public use of parks and verges can act as barriers to gardening. In the 1970s, guerrilla gardening emerged as a clandestine, environmentally conscious, grassroots activity to reclaim and transform neglected or derelict urban spaces into healthy green spaces. Although not as subversive since its inception, guerrilla gardening in cities is as much a recreational activity as it is an ecological statement of urban activism, which effectively provides urban dwellers an entry point to engage with the outdoors for the planting of edible and nonedible plants in artificial places and spaces where natural life struggles to exist. Guerilla gardening has been impactful to city life through its contributions and controversies in improving urban ecosystems, educating neighbors on nutrition and food production where gardens crop up, and broadly to the health of humans (and other creatures) who live there.


Urbanization in the Global South  

Warren Smit

The term “global South” (or just “South” or “south”) refers to the diverse range of countries in Asia, Africa, and Latin America that have a colonial past and are usually characterized by high levels of poverty and informality. The term global South has widely replaced other, similar, terms such as the Third World, developing countries, and low- and middle-income countries. Urbanization, in its narrow sense, refers to an increase in the proportion of the population living in urban areas; in its wider sense it refers to all the social, economic, biophysical, and institutional changes that result from and accompany urban growth, many of which have a profound impact on human health and well-being. The global South is the most rapidly urbanizing part of the world. Since about 2015, more than 75% of the world’s urban population lives in the global South. It is projected that by 2025, the urban population of the global South will be 3.75 billion (54.3% of the total population of the global South). Most of this urbanization is as a result of urban areas having higher natural population growth rates than rural areas, but migration to urban areas also plays a significant role. Although urbanization processes vary considerably across different countries in the global South (e.g., between different regions and between middle-income and low-income countries), there are a number of broad common trends: a rapid increase in the number of megacities (urban agglomerations with a population of more than 10 million), ongoing strong urban–rural linkages and increased blurring of “urban” and “rural,” increased urban sprawl and fragmentation, and growing intra-urban inequalities. There has been much debate about the nature of cities and urban life in the global South, giving rise to a body of literature on “southern urbanism,” characterized by case studies of everyday life. Urbanization processes in the global South have contributed to the growth and complexity of the burden of disease. Infectious diseases have continued at high levels due to poor environmental conditions in many parts of cities, particularly in informal settlements and other types of slums. Noncommunicable diseases are also growing rapidly in the global South, linked to changes in living conditions and lifestyle associated with urbanization. It is anticipated that the burden of disease in cities of the global South will continue to increase as urbanization continues, as a result of increased traffic injuries and respiratory disease resulting from increased numbers of motor vehicles; growing levels of violence due to growing levels of poverty and inequality in many cities; growing obesity as a result of changed lifestyles associated with urbanization; growing numbers of unsafe settlements in hazardous areas; and a high risk of infectious diseases. Climate change is likely to exacerbate these risks.


Water Safety Plans  

Karen Setty and Giuliana Ferrero

Water safety plans (WSPs) represent a holistic risk assessment and management approach covering all steps in the water supply process from the catchment to the consumer. Since 2004, the World Health Organization (WHO) has formally recommended WSPs as a public health intervention to consistently ensure the safety of drinking water. These risk management programs apply to all water supplies in all countries, including small community supplies and large urban systems in both developed and developing settings. As of 2017, more than 90 countries had adopted various permutations of WSPs at different scales, ranging from limited-scale voluntary pilot programs to nationwide implementation mandated by legislative requirements. Tools to support WSP implementation include primary and supplemental manuals in multiple languages, training resources, assessment tools, and some country-specific guidelines and case studies. Systems employing the WSP approach seek to incrementally improve water quality and security by reducing risks and increasing resilience over time. To maintain WSP effectiveness, water supply managers periodically update WSPs to integrate knowledge about prior, existing, and potential future risks. Effectively implemented WSPs may translate to positive health and other impacts. Impact evaluation has centered on a logic model developed by the Centers for Disease Control and Prevention (CDC) as well as WHO-refined indicators that compare water system performance to pre-WSP baseline conditions. Potential benefits of WSPs include improved cost efficiency, water quality, water conservation, regulatory compliance, operational performance, and disease reduction. Available research shows outcomes vary depending on site-specific context, and challenges remain in using WSPs to achieve lasting improvements in water safety. Future directions for WSP development include strengthening and sustaining capacity-building to achieve consistent application and quality, refining evaluation indicators to better reveal linked outcomes (including economic impacts), and incorporating social equity and climate change readiness.


Well-Being Economics  

Paul Dalziel and Trudi Cameron

A strong social gradient in the experience of health means that a person’s health tends to reflect social position. There is strong evidence that average health outcomes in a country tend to be poorer when income inequality is greater. Consequently, public health policy is influenced by a country’s economic situation. Adopting principles in the Helsinki Statement on Health in All Policies, this means governments should pay attention to the public health implications of its economic policies, moving beyond simple analyses of how policy might support growth in gross domestic product. Since 2009, a global movement has aimed to shift the emphasis of economic policy evaluation from measuring economic production to measuring people’s well-being. This approach is known as well-being economics. Many countries have engaged with citizens to create their own national well-being framework of statistical indicators. Some countries have passed legislation or designed new institutions to focus specific policy areas on promoting the well-being of current and future generations. A small number of countries are attempting to embed well-being in their core economic policies. Further policy work and research are required for the vision of a well-being economy to be realized.